title: Dramatic reversal of derangements in muscle metabolism and left ventricular function after bariatric surgery.
abstract: OBJECTIVE
  The study objective was to define muscle metabolic and cardiovascular changes after surgical intervention in clinically severe obese patients.
  
  
  METHODS
  Obesity is a state of metabolic dysregulation that can lead to maladaptive changes in heart and skeletal muscle, including insulin resistance and heart failure. In a prospective longitudinal study, 43 consecutive patients underwent metabolic profiling, skeletal muscle biopsies, and resting echocardiograms at baseline and 3 and 9 months after bariatric surgery.
  
  
  RESULTS
  Body mass index decreased (mean changes, 95% confidence interval [CI]): 7.7 kg/m(2) (95% CI, 6.70-8.89) at 3 months and 5.6 kg/m(2) (95% CI, 4.45-6.80; P<.0001) at 9 months after surgery, with restoration of insulin sensitivity and decreases in plasma leptin at the same time points. Concurrent with these changes were dramatic decreases in skeletal muscle transcript levels of stearoyl coenzyme-A desaturase and pyruvate dehydrogenase kinase-4 at 3 and 9 months (P<.0001, for both) and a significant decrease in peroxisome proliferation activated receptor-alpha-regulated genes at 9 months. Left ventricular relaxation impairment, assessed by tissue Doppler imaging, normalized 9 months after surgery.
  
  
  CONCLUSIONS
  Weight loss results in the reversal of systemic and muscle metabolic derangements and is accompanied by a normalization of left ventricular diastolic function.
authors.affiliation: Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
authors.forename: Joshua G
authors.initials: JG
authors.lastname: Leichman
authors.forename: Erik B
authors.initials: EB
authors.lastname: Wilson
authors.forename: Terry
authors.initials: T
authors.lastname: Scarborough
authors.forename: David
authors.initials: D
authors.lastname: Aguilar
authors.forename: Charles C
authors.initials: CC
authors.lastname: Miller
authors.forename: Sherman
authors.initials: S
authors.lastname: Yu
authors.forename: Mohamed F
authors.initials: MF
authors.lastname: Algahim
authors.forename: Manuel
authors.initials: M
authors.lastname: Reyes
authors.forename: Frank G
authors.initials: FG
authors.lastname: Moody
authors.forename: Heinrich
authors.initials: H
authors.lastname: Taegtmeyer
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D004452:Echocardiography; D005260:Female; D015870:Gene Expression; D006439:Hemodynamics; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000378:metabolism* / Q000473:pathology; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D015431:Weight Loss